Revenue Cycle Manager

Clutch Canada; Deutschland; Remote; EUR 76.000 - 99.000; Vollzeit

Zusammenfassung

A women's healthcare company is seeking a Revenue Cycle Manager to oversee credentialing and the revenue cycle process. This managerial role involves leading a specialized team, establishing performance metrics, and ensuring efficient claim processes. Ideal candidates should have strong leadership and analytical skills. The position offers a salary range of $90,000 - $115,000 and includes benefits such as unlimited vacation and medical coverage.

Leistungen

Unlimited vacation

Free membership

Competitive stock options

$300 WFH stipend

$50/month phone reimbursement

Medical, dental, and vision benefits

401k program

Top of the line Macbook Pro

Travel stipend for team off-sites

Qualifikationen

• Ability to lead a diverse team.
• Engage with partners to solve complex problems.
• Create policies aligned with organizational goals.

Aufgaben

• Lead a team of credentialing specialists and billing leads.
• Establish and monitor KPIs for effectiveness of billing processes.
• Identify and resolve potential revenue leakage.
• Minimize rejections and denials in claims submissions.
• Ensure timely payment posting from lockbox.
• Oversee enrollment for EDI and EFT with payers.

Kenntnisse

Leadership

Data analysis

Problem solving

Collaboration

Jobbeschreibung

Overview

Tia is on a mission to transform healthcare for women by increasing access to and improving the experience of key preventive healthcare services. Tia’s preventive care model integrates key services across primary care, mental health, gynecology, dermatology and other wellness services. Tia blends in-person and virtual care services with a "Whole Woman, Whole Life" care model that treats women as whole people and supports life-long care. By making women’s health higher quality and lower cost, Tia aims to improve outcomes, support providers, and strengthen the business of care delivery.

Role Summary

Role Title: Revenue Cycle Manager

This role oversees the entire credentialing process at Tia as well as the back end of the revenue cycle process from the time we receive a rejection, denial, or remit from the payer through to payment posting. The role will lead a team to ensure that our providers are effectively tracked through credentialing and enrollment and will work closely with market partners to ensure contracts are set up correctly. The role will create repeatable and optimal systems and operating procedures for enrolling providers, setting up contracts, and identifying and troubleshooting issues. It will also lead the backend billing and revenue cycle function, delineate responsibilities between internal operations and the patient accounting system vendor, and ensure claims are paid quickly and accurately. The position will create key performance metrics to ensure the team operates at an excellent level aligned with the organization’s goals.

Key responsibilities

• Team Leadership: Lead a team of credentialing specialists and billing leads, providing guidance, coaching, and direction to foster a collaborative and high-performance culture.
• Performance Metrics: Establish and monitor KPIs to measure the effectiveness and efficiency of the billing and credentialing team. Analyze metrics and implement initiatives to meet or exceed targets.
• Identifying and Resolving Revenue Leakage: Identify and resolve potential revenue leakage within the revenue cycle. Use a strategic, data-driven approach to analyze processes, identify gaps, and implement targeted solutions in collaboration with cross-functional teams.
• Rejections and Denials: Lead a dedicated team to minimize rejections and denials by improving claims submission and validation processes. Develop measures to address rejections, reduce denials, and optimize reimbursements using analytics.
• Underpayments: Establish a process to identify underpayments, review payment discrepancies, and ensure payments align with contracts and fee schedules.
• Payment Posting / Lockbox Management: Ensure accurate and timely recording of payments from the lockbox and virtual payments in the patient accounting system.
• EDI / EFT Enrollment: Oversee enrollment for EDI and EFT with payers. Maintain strong relationships with market partners and payers to facilitate smooth enrollment.
• Credentialing and Enrollment: Lead a credentialing and enrollment team to ensure timely and accurate provider credentialing with various payers. Implement best practices to streamline enrollment and stay current on regulations and payer requirements.
• Payer Management: Develop and maintain relationships with market partners and payers. Collaborate with cross-functional teams to address payer-related challenges.

Competencies

• Leadership and Team Management: Ability to lead a diverse team, assess strengths and opportunities, and empower individuals to contribute to department and organizational success.
• Dynamic Cross-Functional Collaboration: Use organizational and RCM knowledge to engage with optimal partners and create solutions to complex problems.
• Lead a Healthy Culture: Foster belonging, trust, and accountability within the team and across partners.
• Process Development & Optimization: Design and improve processes to enhance efficiency and performance; analyze workflows to remove bottlenecks.
• Policy Development: Create actionable policies aligned with goals; conduct research and collaborate with stakeholders to produce clear guidelines.
• Implementation and Tracking of Operating Procedures: Lead new procedures, coordinate cross-functional rollout, provide training, and establish tracking to monitor effectiveness.
• Problem Solving: Tackle complex problems with analytical methods, identify root causes, and implement improvements.
• Communication and Collaboration: Clear verbal and written communication; foster inter-team collaboration and maintain relationships across departments.

Salary: $90,000 - $115,000

Benefits

• Unlimited vacation
• Free Tia membership
• Competitive stock option package
• $300 one-time WFH stipend
• $50/month phone and internet reimbursement
• Medical, dental, and vision benefits
• 401k program (no matching at this time)
• Top of the line 13" Macbook Pro
• Travel stipend for team off-sites

About Us

Founded in 2017 by Carolyn Witte and Felicity Yost, Tia is the modern medical home for women. We are trailblazing a new paradigm for women’s healthcare that treats women as whole people vs. parts or life stages. Blending in-person and virtual care services, Tia’s “Whole Woman, Whole Life” care model fuses gynecology, primary care, mental health and evidence-based wellness services to treat women comprehensively. By making women’s health higher quality and lower cost, Tia makes women healthier, providers happier, and the business of care delivery stronger — setting a new standard of care for women everywhere.

Tia has raised more than $132 million in venture capital funding to date, including a recent $100 million Series B investment. Tia has ambitious plans to scale its model to more than 100,000 women with blended care in multiple markets and service lines. Since launching in 2017, Tia has grown to serve thousands of women aged 18-80 with blended in-person and virtual care in New York City, Los Angeles, Phoenix and other markets.

We’re building a world-class team to reimagine women’s healthcare. We’re an interdisciplinary team united by a mission and values that define our business, products, and culture.

Tia is building a culture of excellence — in people, process and product. We value excellence as continuous improvement, collaboration, and bold problem solving. We are an equal opportunity employer and celebrate diversity of experience and perspective. We encourage people of color and members of the LGBTQ+ community to apply. If you are committed to collaborative problem solving, creating high-quality user-centric products, and want to make waves in women’s healthcare, join us!